Source: Web exclusive, June 2010
The G8 Summit is about much more than expensive indoor lakes and security fences. Every time world leaders gather together for this event, they focus on specific issues, such as HIV-AIDS, climate change or African development. One of the major issues at this year’s summit will be maternal, newborn and children’s health. Prime Minister Stephen Harper said in January that this would be the ‘signature focus’ when leaders gather in Canada.
Why this issue? Back in 2000, 192 nations set eight Millennium Development Goals (MDGs) to be achieved by 2015. These included reducing the world’s number of hungry people by half and providing primary schooling for all boys and girls. Reducing the number of women who die during pregnancy or childbirth by three quarters was one of these goals and so far, maternal health has made the least amount of progress of all the health-related MDGs.
‘It is definitely going to be the most important issue on the G8 agenda,’ says Jenilee Guebert, director of research with the G8 Research Group in the Global Health Diplomacy Program at the Monk School of Global Affairs in Toronto. ‘The reason they chose this issue is because we are so far behind on reaching this Millennium Development Goal.’
In order to meet the child and maternal health MDGs by 2015, its going to take an estimated $30 billion which will help fund the 2.5 million healthcare professionals and one million community healthcare workers needed.
Here’s why it’s important to reach the maternal health MDG:
1. Millions of mothers are dying
According to the United Nations Population Fund (UNFPA), the global maternal death rate has remained ‘stagnant’ over the past decade because maternal health is the least funded of all the Millennium Development goals, and is the one that the world is farthest behind in reaching. UN Secretary-General Ban Ki-moon has termed the continued prevalence of women suffering pregnancy-related deaths a ‘scandal.’ While the number of child deaths fell from around 13 million in 1990 to less than 10 million in 2006, the number of maternal mortalities has remained virtually static.
‘This is an unacceptable situation, and we are all responsible for it because it has never been funded correctly,’ says Dr. Luc de Bernis, senior maternal health advisor for the UNFPA.
2. Death in childbirth can be prevented
Although the number of women who suffer pregnancy-related deaths in Canada is among the world’s lowest, it is a real risk for women in poor countries who do not have access to reproductive health care. Every minute a woman dies in childbirth somewhere around the world’more than half a million mothers are lost every year. Women in developing countries, especially in sub-Saharan Africa, are most at risk’one in seven women in Niger will die due to complications from pregnancy or childbirth.
The main reason for these shocking statistics: too many women are giving birth without a trained or skilled attendant who is capable of alleviating haemorrhaging (the leading cause of death) by providing the hormone oxytocin, preventing an obstructed labour by delivering by Caesarean, or providing basic post-partum shots for tetanus and other infectious diseases. With the proper care and supplies, these complications are highly treatable’Canadian women are also at risk for labour complications, but access to care saves more lives here.
3. Caring for women saves children
Improving the chances of survival and the overall health for mothers also means giving their children a greater chance at living.
‘And we’re not just talking about their newborn babies’research shows that when mothers die, the other children in the family have a much greater likelihood of dying,’ says Susan White, Executive Director of the Canadian Women’s Health Network. In fact, according to the UN, children whose mothers died in birth are ten times more likely to die prematurely. ‘The bottom line is that saving mothers’ lives also saves children’s lives,’ she says.
4. Funding can help treat birth-related injuries
For every woman who dies in childbirth, another 20’about 10 million every year’will suffer from related injuries, infections and diseases that saddle them with a lifetime of pain, suffering and humiliation.
One of the most horrific injuries: fistula, which occurs when the pressure from an obstructed birth leaves a hole between the vagina and the bladder or rectum. These holes can be surgically repaired, but in poor countries women are often left untreated, and have to suffer the pain and humiliation of losing the ability to control the flow of excrement from their bodies for the rest of their lives.
‘There is intense stigmatisation for these women, who are often totally abandoned by their partners and their families,’ says de Bernis. ‘It is very common for us to visit remote communities and discover women who have leaked urine or feces for years and years; nobody ever informed them that treatment was possible. It is a terrible situation.’
5. Access to contraception saves lives
Women in parts of the developing world do not have access to contraception mainly because of a decline in funding for family planning in those countries. This funding has ‘dropped dramatically since the mid 1990s’ according to the United Nations Population Fund. The Guttmacher Institute, a nonprofit organization focused on sexual and reproductive health, estimates that in 2007, donor countries came up $2.5 million short in funding the cost of contraceptive care in developing countries.
According to the institute, providing modern family planning techniques to all women worldwide would reduce the number of unintended pregnancies by 53 million, reduce maternal mortality by a third, and ultimately prevent the deaths of almost 800,000 women and children every year.
6. Young women need sex education
In countries where access to contraception is limited, women tend to conceive at younger ages, when they are at even higher risk of complications from pregnancy. Girls aged 15 to 19 are twice as likely to die in childbirth as women in their 20s; teens younger than 15 are at even greater risk.
‘We need to address the sexual education of adolescents,’ says de Bernis. ‘If it is sensitive in our own countries, such as France and Canada, imagine how difficult it is to address in developing nations. It’s almost impossible. We need to face this.’
7. Women are dying from unsafe abortions
The Canadian government has stated that it will not fund programs that provide access to abortions in developing countries as part of its aid package.
However, many experts on maternal health say it’s an issue that needs to be addressed. ‘It is important to note that many of the countries that have the highest number of maternal deaths have limited access to abortion,’ says White. More than 19 million unsafe abortions take place every year, and more than 70,000 women die annually as a result‘and neither figure has changed significantly in a decade, according to the UNFPA.
‘We are very anxious about these declarations from Canadian politicians,’ says the UN’s de Bernis. ‘It is very important to understand that maternal mortality cannot be reduced without improving access to safe abortions, when legal. We cannot pretend to be interested in maternal health without addressing this issue.’
8. It will improve women’s lives
‘This is also a gender issue’it is only women who deal with the real burden of reproduction, only women who face death and disability from childbearing,’ says de Bernis. ‘This really is an issue of human rights.’
Ultimately, improving access to contraception, safe abortions, and the ability to choose when and how many children to have means improving education and social standing for women overall. ‘The fact remains that women’s needs are not as highly valued as they should be,’ says White. ‘The bigger issue ultimately is empowerment of women.’
9. It will benefit the world economy
‘Women who die from giving birth are in the prime of life’they are generally young and active, at a critical stage in life in terms of their role in the economy,’ says White. ‘Loss of their lives is a blow to a nation’s productivity, especially in Africa where it is women who do most of the farming and feed their families.’ Right now $15 billion in productivity is lost every year due to the deaths of mothers in developing countries, according to the UNFPA.
Investing in maternal health is a cost-effective way to save money in the future from the pressures of overpopulation: every dollar spent on family planning will save four dollars in future costs to the health care, housing, and other social infrastructures, according to the UNFPA.
10. Canada can change the world
As host of the summit, Canada is an important player on this issue. If we commit to the $1 billion or more in funding we have pledged for maternal health, Gubert says that other rich nations will feel pressure to step up to the plate. ‘Canadians are proud of their government’s past involvement in initiatives such as international peacekeeping; we think people in other parts of the world should have the same rights that we have in Canada,’ says Guebert. ‘I really think this is an issue that Canadians really care about.’